Long-term effects of SARS-CoV-2 infection in patients with and without chemosensory disorders at disease onset: a psychophysical and magnetic resonance imaging exploratory study.

A preserved sense of smell and taste allows us to understand many environmental "messages" and results in meaningfully improvements to quality of life. With the COVID-19 pandemic, it became clear how important these senses are for social and nutritional status and catapulted this niche chemosensory research area towards widespread interest. In the current exploratory work, we assessed two groups of post-COVID-19 patients who reported having had (Group 1) or not (Group 2) a smell/taste impairment at the disease onset. The aim was to compare them using validated smell and taste tests as well as with brain magnetic resonance imaging volumetric analysis. Normative data were used for smell scores comparison and a pool of healthy subjects, recruited before the pandemic, served as controls for taste scores. The majority of patients in both groups showed an olfactory impairment, which was more severe in Group 1 (median UPSIT scores: 24.5 Group 1 vs 31.0 Group 2, p = 0.008), particularly among women (p = 0.014). No significant differences emerged comparing taste scores between Group 1 and Group 2, but dysgeusia was only present in Group 1 patients. However, for taste scores, a significant difference was found between Group 1 and controls (p = 0.005). No MRI anatomical abnormalities emerged in any patients while brain volumetric analysis suggested a significant difference among groups for the right caudate nucleus (p = 0.028), although this was not retained following Benjamini-Hochberg correction. This exploratory study could add new information in COVID-19 chemosensory long-lasting impairment and address future investigations on the post-COVID-19 patients' research.

Post-traumatic taste disorders: a case series.

Since 1800s there are reports of post-traumatic anosmia, but few studies investigated post-traumatic gustatory deficit and adopted validated evaluation tests. Peripheral and/or central mechanisms may be involved in the genesis of post-traumatic gustatory dysfunction. Beyond a reduction/loss (hypogeusia/ageusia) of gustatory function following a trauma, qualitative taste changes (dysgeusia) may occur. Especially when persistent, taste deficits might be particularly relevant for patient's quality of life and activities of daily life, but knowledge on this topic is limited. Fifty-three consecutive patients with previous head trauma were recruited. Every patient underwent a careful history taking and thorough olfactory and gustatory chemosensory testing by Sniffin'Sticks Extended test, Whole Mouth Test and Taste Strips Test. All patients had olfactory abnormalities (hyposmia: n = 10, functional anosmia: n = 43), while 10 of them (19%) showed taste deficits (dysgeusia: n = 3, dysgeusia with hypogeusia: n = 1, hypogeusia: n = 5, ageusia: n = 1). Here, we report clinical and neuroimaging data and detailed description of four meaningful cases representing central and peripheral injury patterns. Chemosensory evaluation might be useful to explore taste disorder, a still neglected and underestimated sequela of head trauma.

Assessing pathophysiology of cancer anorexia.

PURPOSE OF REVIEW: Cancer anorexia is a negative prognostic factor and is broadly defined as the loss of the interest in food. However, multiple clinical domains contribute to the phenotype of cancer anorexia. The characterization of the clinical and molecular pathophysiology of cancer anorexia may enhance the efficacy of preventive and therapeutic strategies. RECENT FINDINGS: Clinical trials showed that cancer anorexia should be considered as an umbrella encompassing different signs and symptoms contributing to appetite disruption in cancer patients. Loss of appetite, early satiety, changes in taste and smell are determinants of cancer anorexia, whose presence should be assessed in cancer patients. Interestingly, neuronal correlates of cancer anorexia-related symptoms have been revealed by brain imaging techniques. SUMMARY: The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Limiting the assessment of cancer anorexia to questions investigating changes in appetite may impede correct identification of the targets to address.

Cases of two patients whose food aversions disappeared following severe traumatic brain injury.

Following traumatic brain injury (TBI) the complete disappearance of food aversions was observed in the cases of two patients. In one of the cases, a young female, this change in her food aversion was manifested several months after the TBI, from the time when she was able to eat normally. The other patient, a young man, exhibited the disappearance of his food aversion immediately after recovery from his unconscious state following TBI. These results indicate that the disappearance of food aversions was a consequence of TBI.

CT of the brain in taste and smell dysfunction.

Three hundred fifty-four patients with taste and/or smell disorders were evaluated with computed tomography (CT). The largest group was characterized by head trauma (27%), followed by idiopathic causes (26%), postinfluenza-like hyposmia and hypogeusia (15%), and congenital etiologies (14%). Hyposmia and hypogeusia occurred concomitantly in 21%-45%, the percentage varying according to etiologic subgroup. CT abnormalities were found in 108 (31%) of the 354 patients. The most frequent pathologies were frontal encephalomalacia, subfrontal atrophy in the region of the olfactory bulbs, and anterior temporal lobe atrophy. These changes were found alone or in tandem. Some CT findings suggest common cerebral taste and smell centers and common neural pathways and association centers.